A study by the university of hawaiʻi at mānoa’s h ā kūpuna-national Resource Center for Native Hawaiian Elders Sides Sides Light on the End-Off-Life Care Preferences of NATIVE ALEDERENCES of NATIRENCES of NATICES LED by Assistant Professor Miquela Ibrao, UH Researchers and alu Like, Inc., The Study Identtifies Culturally Tailored Strategies to Honor Kūpuna Values.

Published in the Journal of Palliative MedicineThe research is based on interviews with kūpuna in rural area across hawaiʻi. It highlights four key themes:

1. Cultural Traditions in Health Care: Kūpuna often Use Lāʻau Lapaʻau (herbal medicine) and lomilomi (massage) as integral parts of his care.
2. Family-Conservable Decisions: ʻohana (Family) Plays a Crucial Role in Health Care choices, Extending to Deceptioned Ancestors and the ʻāina (land), which are seen as sources of Guidarance and Healing.
3. Preference for Home-Based Care: Many Kūpuna Wish to Age and Die at Home but Fear Burdening their Families. Limited long-term care options in rural areas add to the challenge.
4. Trust in Providers: Kūpuna Value Health Care Providers who “Talk Story” and Understand their culture, fostering trust and respect.

“Death is not an end but a transition that Honors reality, ancestors and the land,” said ibrao. “Decolonizing End-of-Life Care means Respecting Cultural Beliefs and Embracing indigenous wisdom about healing and living well.”

The Researchers Recommend Cultural Humility Training for Providers, Increasing Native Hawaiian Representation in Health Care, and Including Cultural Practitioners in Care Teams. These strategies aim to ensure kūpuna receive compassionate care that aligns with their traditions.